Background/Objectives: The long-term sequelae of COVID-19 pneumonia, particularly the persistence of imaging abnormalities and their relationship to clinical symptoms, remain unclear. While the acute radiologic patterns are well-documented, the transition to chronic pulmonary changes—and their implications for long COVID symptoms—require systematic investigation. Methods: Our study included 93 patients with moderate to severe COVID-19 pneumonia who were admitted to Istanbul Medical Faculty Hospital, each having one follow-up CT scan over a ten-month period. Two thoracic radiologists independently calculated semi-quantitative initial chest CT scores to evaluate lung involvement in pneumonia (0–5 per lobe, total score 0–25). Two radiologists and one pulmonologist retrospectively examined the persistence of follow-up imaging findings, interpreting them alongside the relevant clinical and laboratory data. Additionally, in a subcohort (n = 46), mid-term (5–7 months) and long-term (≥10 months) scans were compared to assess temporal trajectories. Results: Among the 93 patients with long-term follow-up imaging, non-fibrotic changes persisted in 34 scans (36.6%), while fibrotic-like changes were observed in 70 scans (75.3%). The most common persistent non-fibrotic changes were heterogeneous attenuation (29%, n = 27) and ground-glass opacities (17.2%, n = 16), and the persistent fibrotic-like changes were pleuroparenchymal bands or linear atelectasis (58%, n = 54), fine reticulation (52.6%, n = 49), and subpleural curvilinear lines (34.4%, n = 32). Both persistent non-fibrotic and fibrotic-like changes were statistically correlated with the initial CT score (p < 0.001), LDH (p < 0.001), and ferritin levels (p = 0.008 and p = 0.003, respectively). Fatigue (p = 0.025) and chest pain (p < 0.001) were reported more frequently in patients with persistent non-fibrotic changes, while chest pain (p = 0.033) was reported more frequently among those with persistent fibrotic-like changes. Among the 46 patients who underwent both mid- and long-term follow-up imaging, 47.2% of those with non-fibrotic changes (17 out of 36) and 10% of those with fibrotic-like changes (4 out of 40) exhibited regression over the long term. Conclusions: Initial imaging and laboratory findings may indicate persistent imaging findings related to long-term sequelae of COVID-19 pneumonia. Many of these persistent imaging abnormalities, particularly non-fibrotic changes seen in the mid-term, tend to lessen over the long term. A correlation exists between persistent imaging findings and clinical outcomes of long COVID-19, underscoring the need for further research.

This study aims to investigate antiviral effectiveness, side effects, and disease outcomes in patients who have been using entecavir (ETV) and tenofovir disoproxil fumarate (TDF) for a long-term in chronic hepatitis B. Patients with chronic hepatitis B who had been using TDF or ETV for at least 10 years were included in this retrospective study. Co-infected patients, those receiving immunosuppressive therapy, and transplant patients were excluded. Of the study’s total 173 patients (baseline mean age 43.4 ± 11.7 years), 110 (63.6%) were men. Thirty-three (19.1%) patients were cirrhotic, and hepatitis B e-antigen was negative in 131 (75.7%) patients at the baseline. Ninety-two (53.2%) patients used TDF and 81 (46.8%) used ETV for a mean of 156.76 ± 21.60 (120–204) months. Hepatitis B virus (HBV)-DNA negativity (<10 IU/mL) was achieved in 97.7% of all patients. Biochemical remission was achieved in 98.3% of all patients at the last visit. HBsAg became negative in only 5 (2.9%). Hepatocellular carcinoma (HCC) developed in 9 (5.2%) patients. All HCCs occurred after the 5th year of treatment. The age at HBV diagnosis was higher in HCC patients (P = .023), but the most important risk factor for the development of HCC was to have cirrhosis at baseline. Eight (4.6%) patients died in the follow-up, and 2 were due to liver disease and the remaining non-liver disease. At the end of follow-up, HBV-DNA negativity was achieved in almost all patients, and HBsAg sero-clearance was rarely achieved. Very few patients developed HCC and the long-term mortality rate was similar to the general population.

Acquired angioedema (AAE) is a rare, potentially life-threatening condition caused by bradykinin, typically presenting as recurrent, non-pitting facial swelling without urticaria. Unlike hereditary forms, acquired angioedema arises later in life and may be associated with underlying B-cell lymphoproliferative disorders. We report a 62-year-old woman with persistent antihistamine-unresponsive facial angioedema, fatigue, and moderate splenomegaly, which led to further work-up for AAE. Low C4 and C1 inhibitor (C1-INH) was detected, with normal C1q levels. Given the presence of splenomegaly and cytopenia, further evaluation of lymphoproliferative disease was pursued. Bone marrow biopsy confirmed splenic marginal zone lymphoma (SMZL), and rituximab-based chemotherapy resulted in full remission of both lymphoma and angioedema. This case highlights the importance of evaluating elderly patients with unexplained angioedema and organomegaly for hidden lymphoproliferative disease. Treating the underlying disease can resolve symptoms and improve outcomes.

Objective: This study aimed to evaluate the relationship between vertebral fracture and various biological factors in patients with type 1 diabetes mellitus (T1DM). Methods: The study included 61 patients diagnosed with T1DM who were evaluated in the Diabetes Outpatient Clinic between 2017 and 2019, and 49 healthy individuals forming the control group. Demographic and clinical characteristics (age, gender, hypertension, hyperlipidemia, obesity), biochemical parameters (fasting blood glucose, HbA1c, calcium, phosphate, parathyroid hormone, 25-OH vitamin D, C-terminal telopeptide, osteocalcin, alkaline phosphatase), and bone-related variables (L1–L4 and femoral neck bone mineral density [BMD], vertebral fracture status) were comprehensively collected during outpatient visits. Vertebral fractures were assessed by the Genant semi-quantitative method using lateral vertebral fracture assessment images obtained by dual-energy X-ray absorptiometry. Data were analyzed using non-parametric statistical tests and expressed as median (interquartile range). Logistic regression analysis adjusted for age, sex, body mass index (BMI), and phosphate levels was performed. Results: Vertebral fracture prevalence was significantly higher in T1DM patients (67.2%) compared with controls (26.5%, P < .001). Patients had significantly lower body weight and BMI and higher rates of hyperlipidemia. Femoral neck BMD was significantly lower in the T1DM group (0.967 vs. 1.193 g/cm2, P < .001). Among diabetic patients, those with vertebral fractures had significantly lower serum phosphate levels than those without fractures (3.20 vs. 3.85 mg/dL, P = .008). No significant differences were observed in bone turnover markers or BMD values between patients with and without fractures. Conclusion: Type 1 diabetes mellitus patients showed a markedly higher prevalence of vertebral fractures and lower femoral neck BMD compared with healthy controls. Lower phosphate levels were observed in patients with fractures, suggesting a potential role of phosphate metabolism in diabetic bone fragility. Cite this article as: Günhan HG, .etin O, İmre E, Gogas Yavuz D. Bone mineral density and vertebral fracture frequency in a group of type 1 diabetic patients. Cerrahpaşa Med J. 2026, 50, 0091, doi: 10.5152/cjm.2026.25091.

Objective: Trans-fatty acids (TFAs) pose several risks to human health. World Health Organization recommends the elimination of trans-fat consumption through limiting their use as less than 2g/100g fat. In line with this recommendation, Turkey recently passed a new regulation securing the content of TFAs as less than 2g/100g fat in industrially produced foods. The objective of this study was to determine the proportion of high TFA (>2 g/100g fat) in pastries among socioeconomically disadvantaged communities of Istanbul before the regulation was put into force. Patients and Methods: Eight socioeconomically disadvantaged districts were chosen from Istanbul and from each district three neighborhoods with the lowest land values were identified. Pastry samples were collected from 72 shops. TFA content was analyzed at Scientific and Technological Research Council of Turkey (TUBITAK) Marmara Research Center by the ISO 12966-2:2011 method. p0.05). Conclusion: HOur findings indicate that Turkey could easily comply with the legislative limit of 2%. Still, the compliance should continuously be evaluated in diverse populations of the country.